Personal health budgets: challenges for commissioners and policy-makers: research summary

Nuffield Trust
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The purpose of a personal health budget is to give people much more control over how their needs are met, what services they receive and who delivers them. It is not intended to meet individuals' entire health needs; rather, to enable the purchase of services they think will improve certain aspects of their health and wellbeing. In 2009 the Department of Health launched a pilot programme in England to look at the viability of personal health budgets, and an independent evaluation was carried out. This evaluation used a controlled trial to compare the experiences of just over 1,000 people selected to receive a personal health budget with those of just over 1,000 continuing with conventional support arrangements across six conditions: chronic obstructive pulmonary disease, diabetes, long-term neurological conditions, mental health, stroke, and patients eligible for NHS continuing health care. It was found that personal health budgets have a positive impact on care-related quality of life and wellbeing and are cost-effective. It was recommended that they should have a wider roll-out. The Government has since committed that from April 2014 everyone who receives NHS continuing health care funding will have a right to request a personal health budget, rather than receiving commissioned services. In this research summary the authors describe what personal health budgets are and how they are supposed to work in practice. They examine some of the evidence on personal health budgets in relation to questions of efficacy, cost-effectiveness, risk and safeguarding and fraud. They also explore some of the issues that will be raised for commissioners and policy-makers as personal health budgets are introduced more widely. More positively, they also note opportunities for greater integration between health and social care. A case study illustrates one example of a a personal budget being used successfuly in practice. The authors conclude that while much has been learned from the pilot programme, pressures on the NHS budget and changes with the introduction of clinical commisisoning groups CCGs) make it difficult to ascertain the financial sustainability of personal budgets. (Original abstract)

Subject terms:
personal budgets, health needs, NHS, wellbeing, evaluation, health, long term conditions, integrated services, social care, commissioning, clinical commissioning groups, personal health budgets;
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